Curtis J R
Department of Medicine, University of Washington, Seattle, USA.
New Horiz. 1998 Feb;6(1):26-32.
There is a growing recognition that clinical research needs to define and focus on the outcomes of medical care which are important to patients. The outcomes important to patients have been coined "patient-centered" outcomes. In the past, clinical research in critical care medicine has tended to focus on survival and physiologic impairment, and not as much on outcomes such as functional status and quality of life. While survival and physiologic impairment are the appropriate outcomes in some settings, we also need to address important questions about the effect of critical care medicine on other outcomes. The goals of this article are to describe the patient-centered outcomes of critical care research, to identify important issues and pitfalls in measuring these outcomes, and to identify the situations in which these outcomes may be more or less important. The outcomes addressed include: mortality, patient-assessed outcomes (quality of life, functional status, and health status), physiologic parameters, process-of-care measures, and quality of death.
人们越来越认识到，临床研究需要界定并关注对患者至关重要的医疗护理结果。对患者重要的结果被称为“以患者为中心”的结果。过去，重症医学的临床研究往往侧重于生存率和生理功能损害，而对功能状态和生活质量等结果关注较少。虽然在某些情况下，生存率和生理功能损害是恰当的结果，但我们也需要解决有关重症医学对其他结果影响的重要问题。本文的目的是描述重症监护研究中以患者为中心的结果，识别测量这些结果时的重要问题和陷阱，并确定这些结果可能或多或少重要的情况。所涉及的结果包括：死亡率、患者评估的结果（生活质量、功能状态和健康状况）、生理参数、护理过程指标以及死亡质量。
